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Outcome of upfront combination chemotherapy followed by chemoradiation for locally advanced pancreatic adenocarcinoma

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Abstract

Purpose

The role and timing of chemotherapy and radiation for treating stage III pancreatic adenocarcinoma remains controversial.

Methods

Treatment-naive patients with stage III non-resectable pancreatic adenocarcinoma were treated with PEFG/PEXG (cisplatin, epirubicin, 5-fluorouracil (F)/capecitabine (X), gemcitabine) or PDXG (docetaxel substituting epirubicin) regimen for 6 months followed by radiotherapy (50–60 Gy) with concurrent F or X or G.

Results

Ninety-one patients were registered between April 1997 and December 2007. Forty-three patients (47%) had a partial remission and 38 (42%) had a stable disease. Thirteen patients (14%) were radically resected yielding one pathologic complete remission. Median survival (OS) was 16.2 months. Median progression-free survival was 9.9 months. Pattern of failure consisted of isolated local failure (N = 26, 35%); both local and systemic failure (N = 14, 19%); isolated systemic failure (N = 35, 47%).

Conclusion

Combination chemotherapy with four-drug regimens followed by chemoradiation was a feasible strategy showing relevant results in stage III pancreatic adenocarcinoma.

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Authors and Affiliations

  1. Department of Oncology, S. Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy

    Michele Reni, S. Cereda, A. Rognone, E. Mazza & E. Villa

  2. Department of Surgery, S. Raffaele Scientific Institute, Milan, Italy

    G. Balzano, A. Zerbi & V. Di Carlo

  3. Department of Radiotherapy, S. Raffaele Scientific Institute, Milan, Italy

    P. Passoni

  4. Department of Radiology, S. Raffaele Scientific Institute, Milan, Italy

    R. Nicoletti

  5. Department of Gastroenterology, S. Raffaele Scientific Institute, Milan, Italy

    P. G. Arcidiacono

Authors
  1. Michele Reni
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  2. S. Cereda
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  3. G. Balzano
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  4. P. Passoni
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  5. A. Rognone
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  6. A. Zerbi
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  7. R. Nicoletti
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  8. E. Mazza
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  9. P. G. Arcidiacono
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  10. V. Di Carlo
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  11. E. Villa
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Correspondence to Michele Reni.

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Reni, M., Cereda, S., Balzano, G. et al. Outcome of upfront combination chemotherapy followed by chemoradiation for locally advanced pancreatic adenocarcinoma. Cancer Chemother Pharmacol 64, 1253–1259 (2009). https://doi.org/10.1007/s00280-009-0995-8

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  • DOI: https://doi.org/10.1007/s00280-009-0995-8

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